Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Wien, Austria.
Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Wien, Austria.
BMJ Ment Health. 2024 Aug 25;27(1):e301061. doi: 10.1136/bmjment-2024-301061.
Diabetes increases the risk of psychosocial health problems. Person-centred psychosocial care is therefore advocated. However, several barriers to implementation exist, including uncertainty about how to approach psychosocial problems in consultations.
We aimed to explore which psychosocial outcomes patients and healthcare professionals consider important and whether certain characteristics are associated with this. We propose strategies for facilitating psychosocial diabetes care on this basis.
The results of an international Delphi study aimed at achieving multi-stakeholder consensus on a diabetes outcome set were analysed. We compared the importance ratings of the two stakeholder groups for each psychosocial outcome. A multivariable linear regression analysis tested whether certain characteristics would predict the importance attributed to outcomes that were not generally considered important.
Patients and healthcare professionals agreed on the importance of regularly assessing psychological well-being, diabetes distress and diabetes-specific quality of life, while they regarded it as less important to monitor depression, anxiety, eating problems, social support and sexual health. Being a woman, younger and living with type 1 diabetes were associated with considering it important to assess eating problems.
We propose two psychosocial care pathways that reflect the outcome preferences of patients and healthcare providers. They follow a stepped approach, starting with the assessment of psychological well-being and quality of life and proceeding from there.
Adopting this approach can facilitate the implementation of person-centred psychosocial diabetes care by reducing the burden and making psychosocial issues more accessible. This approach should be tested for feasibility, safety and effectiveness.
糖尿病会增加心理社会健康问题的风险。因此提倡以患者为中心的心理社会护理。然而，实施过程中存在多种障碍，包括不确定如何在咨询中处理心理社会问题。
我们旨在探讨患者和医疗保健专业人员认为哪些心理社会结果重要，以及某些特征是否与之相关。在此基础上，我们提出了促进心理社会糖尿病护理的策略。
对旨在就糖尿病结果集达成多方利益相关者共识的国际 Delphi 研究的结果进行了分析。我们比较了两组利益相关者对每个心理社会结果的重要性评分。多变量线性回归分析检验了某些特征是否会预测对通常认为不重要的结果的重要性。
患者和医疗保健专业人员对定期评估心理幸福感、糖尿病困扰和糖尿病特定生活质量的重要性达成一致，但他们认为监测抑郁、焦虑、饮食问题、社会支持和性健康的重要性较低。女性、年轻和 1 型糖尿病患者与认为评估饮食问题很重要有关。
我们提出了两种心理社会护理途径，反映了患者和医疗保健提供者的结果偏好。它们遵循逐步的方法，从评估心理幸福感和生活质量开始。
采用这种方法可以通过减轻负担和使心理社会问题更容易获得，从而促进以患者为中心的心理社会糖尿病护理的实施。应测试这种方法的可行性、安全性和有效性。
